The Global Fund Grant
The Global Fund is an organisation designed to accelerate the end of the AIDS, tuberculosis and malaria epidemics. Since its creation in 2002, the Global Fund has contributed to more than 155 counties in the fight against TB, HIV and malaria.
The health investments through the global fund have saved 38 million lives and provided prevention, treatment and healthcare services, helping to restore communities, strengthen local health systems and improve economies.
As a partnership of governments, civil society, technical agencies, the private sector and people affected by the diseases, the Global Fund pools the world’s resources to invest strategically in programs to end AIDS, TB and malaria as epidemics, and is responsible for 65% of all the international funding for interventions and programs regarding all forms of TB.
Between 2018 and 2020, the Global Fund decided to give special attention to the 13 countries that contribute to 75% of all missing cases, South Africa being one of them.
In 2018
38 million
lives have been saved through Global Fund partnership
Summary: Performance in Nelson Mandela Bay District
Scientific advances and innovative ideas are unlocking improvements in disease prevention, treatment and care. A chest X-ray is a rapid imaging technique that allows lung abnormalities to be identified, and have been one of the primary tools for detecting TB as it has a high sensitivity for pulmonary TB.
Recently, chest X-rays are being promoted as a useful tool that can be placed early in screening and triaging. Numerous national TB prevalence surveys have demonstrated that chest X-rays are the most sensitive screening tool for pulmonary TB and for people with TB who are asymptomatic – at least early in the course of the disease. Read More
Nutritional Support Programme
There is increasing evidence that undernutrition in patients with active TB is associated with an increased frequency and severity of disease and indeed a two to four-fold increase in mortality. TB is commonly accompanied by comorbidities such as HIV, diabetes, smoking and alcohol or substance abuse which have their own nutritional implications.
A less than ideal weight gain during TB treatment also increases the risk of long-term relapse even after initial cure. Undernutrition has also been associated with malabsorption of key anti-TB drugs. Therefore, TB and undernutrition can cause a vicious cycle of worsening disease and undernutrition. Read More
Food Parcels
Various studies have shown a strong link between nutrition and TB. There is increasing evidence that undernutrition in patients with TB is associated with an increased frequency and severity of disease and indeed a two to four-fold increase in mortality.
TB is commonly accompanied by comorbidities such as HIV, diabetes, smoking and alcohol or substance abuse which have their own nutritional implications. There is also a five-fold risk of drug-induced liver damage. A less than ideal weight gain during TB treatment also increases the risk of long-term relapse even after initial cure.
Undernutrition has also been associated with malabsorption of key anti TB drugs. Therefore, TB and undernutrition can cause a vicious cycle of worsening disease and undernutrition.
Poverty and food insecurity are both causes and consequences of TB, and those involved in TB care, therefore, play an important role in recognizing and addressing these wider socio-economic issues.
AQUITY’s nutritional support programme commenced in August and has been fully implemented in both the Ehlanzeni and OR Tambo districts.
Where We Work
AQUITY has digital chest X-ray containers in two districts, OR Tambo, Eastern Cape; andEhlanzeni, Mpumalanga. We have used geographical information system (GIS) mapping to place the X-ray containers in communities with a high TB burden:
The Ehlanzeni District Municipality is situated in the north-east of the Mpumalanga province. It makes up just overa third of the province’s geographical area. The district is comprised of four local municipalities:
Bushbuckridge, City of Mbombela, Nkomazi and Thaba Chweu.
The district has an estimated population of 1.7 million which makes up about 40% of the total population of theMpumalanga province. Most of the population is concentrated within the City of Mbombela, which is also the home ofthe Mpumalanga Provincial Government and, as a result, is the most the concentrated economic hub within theprovince. As such, AQUITY has decided to work exclusively in the Ehlanzeni district.
Msogwaba CHC, City of Mbombela Mpumalanga, Dwarslooop CHC, Bushbuckridge, Mpumlalanga
The OR Tambo District Municipality is situated along the eastern part of the Eastern Cape province. The ORTambo district is largely rural, with only 9.3% of the population living in the urban areas.
The district has an estimated population of 1.7 million and the population density is 158 per square kilometre. Thepopulation of the OR Tambo district makes the district the second biggest district in the Eastern Cape province. Thelargest proportion of the population is concentrated in the western part of the district around the main urban centreof Mthatha.
Qumbu CHC, Eastern Cape, Lusikisiki Village Clinic, Eastern Cape, Ngangeliziwe CHC, Eastern Cape
How We Work
REDCap is an online database system that enables users to manage data collection in the field easily. Italso has mobile application functionality to help to capture data offline as AQUITY works in areas wherethere may be little to no network coverage. REDCap is used in a few programmes within the Global Fundproject: Digital Chest X-ray Programme, Nutritional Support Programme, Community-based EnrolledNurses Assistant Programme, and data capturers daily activities reporting.
The people responsible for delivering food parcels, use the tablets to capture patients’ information in thehousehold using the REDCap mobile app functionality, while also capturing the location coordinates thatwill be used in geospatial analysis. REDCap allows multiple entries for one patient; this means we cancapture as much as we need for one patient. Read More
Agnes Sithole, 67
Agnes Sithole, a 67-year-old woman says her confidence in government public health has been restored. Her reluctancy to government health care system was due to the long queues, amongst other reasons, which led her to visit a private doctor, but her health deteriorated further. Her sisters ended up taking her toTekwane Clinic.
She was screened by an AQUITY ENA who collected her sputum for testing. She was diagnosed with TB and wasinitiated to treatment in August 2020. Before visiting theclinic, she had lost hope that she would survive, however,with the support of health care workers who showedgreat care, she was able to recover.
The nutritional and psychosocial support provided by AQUITY was also a valuable factor to her health. She felt blessed that when there was not enough food at her house, the food parcels came at the right time which eased her adherence to treatment; it reduced her trips to neighbours to ask for food in order to take her medication properly.
“I think God put everyone in my path for me to recover, people actually thought I was going to die”
